Prehospital vital sign monitoring in paediatric patients: an interregional study of educational interventions

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Abstract

Background

Prehospital vital sign documentation in paediatric patients is incomplete, especially in patients ≤ 2 years. The aim of the study was to increase vital sign registration in paediatric patients through specific educational initiatives.

Methods

Prospective quasi-experimental study with interrupted time-series design in the North Denmark and South Denmark regions. The study consecutively included all children aged < 18 years attended by the emergency medical service (EMS) from 1 July 2019 to 31 December 2021. Specific educational initiatives were conducted only in the North Denmark EMS and included video learning and classroom training based on the European Paediatric Advanced Life Support principles. The primary outcome was the proportion of patients who had their respiratory rate, peripheral capillary oxygen saturation, heart rate and level of consciousness recorded at least twice. We used a binomial regression model stratified by age groups to compare proportions of the primary outcome in the pre- and post-intervention periods in each region.

Results

In North Denmark, 7551 patients were included, while 15,585 patients from South Denmark were used as a reference. Virtually all of the North Denmark EMS providers completed the video learning (98.7%). The total study population involved patients aged ≤ 2 months (5.5%), 3–11 months (7.4%), 1–2 years (18.8%), 3–7 years (16.2%) and ≥ 8 years (52.1%). In the intervention region, the primary outcome increased from the pre- to the post-intervention period from 35.3% to 40.5% [95% CI for difference 3.0;7.4]. There were large variations in between age groups with increases from 18.8% to 27.4% [95% CI for difference 5.3;12.0] among patients aged ≤ 2 years, from 33.5% to 43.7% [95% CI for difference 4.9;15.5] among patients aged 3–7 years and an insignificant increase among patients aged ≥ 8 years (from 46.4% to 47.9% [95% CI for difference − 1.7;4.7]). In the region without the specific educational interventions, proportions were steady for all age groups throughout the entire study period.

Conclusions

Mandatory educational initiatives for EMS providers were associated with an increase in the extent of vital sign registration in paediatric patients ≤ 7 years. Incomplete vital registration was associated with, but not limited to non-urgent cases.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13049-023-01067-z.

Related collections

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Author and article information

Contributors

Vibe Maria Laden Nielsen:

ORCID: http://orcid.org/0000-0003-2838-9612

vibe.n@rn.dk

Morten Breinholt Søvsø:

ORCID: http://orcid.org/0000-0002-3156-5595

morten.soevsoe@rn.dk

Torben Anders Kløjgård: t.kloejgaard@rn.dk

Regitze Gyldenholm Skals:

ORCID: http://orcid.org/0000-0003-2560-4487

r.skals@rn.dk

Alasdair Ross Corfield:

ORCID: http://orcid.org/0000-0003-0878-7867

alasdair.corfield@ggc.scot.nhs.uk

Lars Bender: labe@rn.dk

Hans Morten Lossius: hans.morten.lossius@norskluftambulanse.no

Søren Mikkelsen:

ORCID: http://orcid.org/0000-0002-5187-7027

Soeren.Mikkelsen@rsyd.dk

Erika Frischknecht Christensen:

ORCID: http://orcid.org/0000-0003-3673-9694

efc@rn.dk

Journal

Journal ID (nlm-ta): Scand J Trauma Resusc Emerg Med

Journal ID (iso-abbrev): Scand J Trauma Resusc Emerg Med

Title: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1757-7241

Publication date (Electronic): 14 January 2023

Publication date PMC-release: 14 January 2023

Publication date Collection: 2023

Volume: 31

Electronic Location Identifier: 4

Affiliations

[1 ]GRID grid.5117.2, ISNI 0000 0001 0742 471X, Centre for Prehospital and Emergency Research, Department of Clinical Medicine, Aalborg University Hospital, , Aalborg University, ; Aalborg, Denmark

[2 ]GRID grid.425870.c, Prehospital Emergency Services, ; Aalborg, North Denmark Region Denmark

[3 ]GRID grid.27530.33, ISNI 0000 0004 0646 7349, Unit of Clinical Biostatistics, , Aalborg University Hospital, ; Aalborg, Denmark

[4 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, National Health Service Greater Glasgow and Clyde, , University of Glasgow, ; Glasgow, UK

[5 ]GRID grid.27530.33, ISNI 0000 0004 0646 7349, Paediatric Department, , Aalborg University Hospital, ; Aalborg, Denmark

[6 ]GRID grid.18883.3a, ISNI 0000 0001 2299 9255, Norwegian Air Ambulance Foundation, , University of Stavanger, ; Stavanger, Norway

[7 ]GRID grid.7143.1, ISNI 0000 0004 0512 5013, The Prehospital Research Unit, , Odense University Hospital, ; Odense, Region of Southern Denmark Denmark

Author information

Vibe Maria Laden Nielsen http://orcid.org/0000-0003-2838-9612

Morten Breinholt Søvsø http://orcid.org/0000-0002-3156-5595

Regitze Gyldenholm Skals http://orcid.org/0000-0003-2560-4487

Alasdair Ross Corfield http://orcid.org/0000-0003-0878-7867

Søren Mikkelsen http://orcid.org/0000-0002-5187-7027

Erika Frischknecht Christensen http://orcid.org/0000-0003-3673-9694

Article

Publisher ID: 1067

DOI: 10.1186/s13049-023-01067-z

PMC ID: 9839956

PubMed ID: 36639802

SO-VID: 27a0b197-2d58-45cb-909f-5c4647b90f10

License:

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